Obesity interferes with blood pressure control

By Eleanor McDermid, Senior medwireNews Reporter

Patients who are overweight or obese have a high risk for uncontrolled blood pressure, despite often taking multiple antihypertensive agents, say researchers.

The presence of overweight or obesity also had a significant detrimental effect on patients’ health-related quality of life (HRQoL), especially in women, report Jerzy Chudek (Medical University of Silesia, Katowice, Poland) and colleagues.

Of 11,498 patients who had been receiving antihypertensive treatment for at least 12 months, 46.2% were overweight and 34.5% were obese.

The average duration of antihypertensive medication among obese and overweight participants, at 8.2 and 6.4 years, respectively, was significantly longer than that among normal-weight patients, at 5.8 years. Yet the proportion who had achieved blood pressure control was significantly less, at 18.3% and 26.9%, compared with 37.0% of normal-weight patients.

This was despite obese and overweight patients taking significantly more antihypertensive agents, at an average of 2.8 and 2.5, respectively, compared with 2.1 among normal-weight patients, and a significantly higher percentage taking more than one drug.

Average systolic blood pressure was 146.6 and 143.3 mmHg among obese and overweight patients, respectively, which was significantly higher than the average of 139.8 mmHg among normal-weight patients, and the same pattern was true of diastolic blood pressure.

“Our study confirms that coexistence of obesity and hypertension is associated with worse [blood pressure] control [in] hypertensive subjects, regardless of sex and despite the frequent use of multiple drug regimens,” write the researchers in the Journal of Hypertension.

Obese and overweight patients were also more likely than those of normal weight to have comorbidities, including coronary artery disease, heart failure, and diabetes.

The team also assessed patients’ HRQoL, via their responses on the 12-item Short Form Health Survey. This showed that, among women, being obese or overweight negatively affected all HRQoL domains, with obesity having the greatest impact.

Among men, being obese adversely affected all domains, but being overweight only influenced the physical domains – physical functioning, role physical, bodily pain, vitality, and general health – without having a significant effect on mental HRQoL.

Age also had a strong negative impact on physical HRQoL among men and women, but the effect of obesity persisted after accounting for age and was also independent of the presence of comorbidities. It also proved to be independent of systolic and diastolic blood pressure.

The team therefore concludes that “excessive weight diminishes HRQoL directly as well as indirectly by worsening [blood pressure] control.”

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